Archive for March 31st, 2020
President Trump in his own words
Dana Milbank collected President Trump’s actual statements for a virtual fireside chat:
The coronavirus is very much under control in the USA. We have it totally under control. I’m not concerned at all. It’s one person coming in from China. We pretty much shut it down. It will all work out well. We’re in great shape. Doesn’t spread widely at all in the United States because of the early actions that myself and my administration took. There’s a chance it won’t spread. It’s something that we have tremendous control over.
Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away. One day it’s like a miracle, it will disappear. Just stay calm. It will go away. The Democrats are politicizing the coronavirus. This is their new hoax.
Whatever happens, we’re totally prepared. Totally ready. We’re rated number one for being prepared. We are so prepared like we never have been prepared. Taking early intense action, we have seen dramatically fewer cases of the virus in the United States. We’re very much ahead of everything.
This is a flu. I didn’t know people died from the flu. Here, we’re talking about a much smaller range. It is very mild. Some people will have this at a very light level. Some of them go to work.
The mortality rate is much, much better. In my opinion it’s way, way down. I think it’s substantially below 1 percent. A fraction of 1 percent. I think the numbers are going to get progressively better as we go along. This is just my hunch.
We have very little problem in this country. We only have five people. We only have 11 cases. Out of billions of people, 15 people. They’re getting better, and soon they’re all going to be better, hopefully. We’re going very substantially down, not up.
The United States, because of what I did and what the administration did with China, we have 32 deaths at this point. To this point, and because we have had a very strong border policy, we have had 40 deaths. As of this moment, we have 50 deaths. I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they’re going to be.
Frankly, the testing has been going very smooth. The tests are all perfect. Anybody that wants a test can get a test. The tests are beautiful. We have a tremendous testing setup.
I don’t believe you need 40,000 or 30,000 ventilators. We are very close to a vaccine. A matter of months. You take a solid flu vaccine, you don’t think that could have an impact? Hydroxychloroquine and azithromycin, taken together, have a real chance to be one of the biggest game changers in the history of medicine. Based on very strong evidence.
I would love to have the country opened up and just raring to go by Easter. No way I’m going to cancel the convention. Stock Market starting to look very good to me!
We’re the ones that gave the great response. I’d rate it a 10. We’ve done a fantastic job. I think they should be appreciative. Gallup just gave us the highest rating. The highest on record.
I like this stuff. I really get it. Maybe I have a natural ability. We think it’s going to have a very good ending. We’re going to win faster than people think. I hope.
This blindsided the world! Who could have ever predicted a thing like this? This was something that nobody has ever thought could happen to this country.
I’ve always known this is a real, this is a pandemic. I felt it was a pandemic long before it was called a pandemic. I always treated the Chinese Virus very seriously.
If you’re talking about the virus, no, that’s not under control for anyplace in the world. I was talking about what we’re doing is under control, but I’m not talking about the virus. I didn’t say Easter. It was just an aspiration. I am giving consideration to a QUARANTINE.
It was nobody’s fault. No, just things that happened. I don’t take responsibility at all.
A Major Medical Staffing Company Just Slashed Benefits for Doctors and Nurses Fighting Coronavirus — because profits above all
Isaac Arnsdorf has an interesting report in ProPublica:
Emergency room doctors and nurses many of whom are dealing with an onslaught of coronavirus patients and shortages of protective equipment — are now finding out that their compensation is getting cut.
Most ER providers in the U.S. work for staffing companies that have contracts with hospitals. Those staffing companies are losing revenue as hospitals postpone elective procedures and non-coronavirus patients avoid emergency rooms. Health insurers are processing claims more slowly as they adapt to a remote workforce.
“Despite the risks our providers are facing, and the great work being done by our teams, the economic challenges brought forth by COVID-19 have not spared our industry,” Steve Holtzclaw, the CEO of Alteon Health, one of the largest staffing companies, wrote in a memo to employees on Monday.
The memo announced that the company would be reducing hours for clinicians, cutting pay for administrative employees by 20%, and suspending 401(k) matches, bonuses and paid time off. Holtzclaw indicated that the measures were temporary but didn’t know how long they would last.
“It’s completely demoralizing,” said an Alteon clinician who spoke on the condition of anonymity. “At this time, of all times, we’re putting ourselves at risk but also putting our families at risk.”
Some co-workers are already taking on extra burdens such as living apart from their families to avoid the risk of infecting them, the clinician said. “A lot of sacrifices are being made on the front line that the administration is not seeing because they’re not stepping foot in a hospital,” she said. “I’ve completely lost trust with this company.”
Other employers will soon follow suit, Holtzclaw said, citing conversations with his counterparts across the industry. “You can be assured that similar measures are being contemplated within these organizations and will likely be implemented in the coming weeks,” he wrote.
However, another major staffing company for emergency rooms, TeamHealth, said its employees would not be affected. “We are not instituting any reduction in pay or benefits,” TeamHealth said in a statement to ProPublica. “This is despite incurring significant cost for staffing in anticipation of surging volumes, costs related to quarantined and sick physicians, and costs for PPE as we work hard to protect our clinicians from the virus.”
Alteon and its private-equity backer, Frazier Healthcare Partners, didn’t immediately respond to requests for comment.
Private equity investors have increasingly acquired doctors’ practices in recent years, according to a study published in February in JAMA. TeamHealth was bought by Blackstone Group in 2016; another top staffing firm, Envision Healthcare, is owned by KKR. (The staffing companies have also been implicated in the controversy over “surprise billing.”)
Hospital operators have also announced cuts. Tenet Healthcare, a Dallas-based publicly traded company that runs 65 hospitals, said it would postpone 401(k) matches and tighten spending on contractors and vendors. Emergency room doctors at Boston’s Beth Israel Deaconess Medical Center have been told some of their accrued pay is being held back, according to The Boston Globe. More than 1,100 staffers at Atrius Health in Massachusetts are facing reduced paychecks or unpaid furloughs, and raises for medical staff at South Shore Health, another health system in Massachusetts, are being delayed. Several other hospitals have also announced furloughs. . .
Profits über alles. “Best healthcare system in th world.” Not.
Amazon Fired the Warehouse Worker Who Organized a Walkout Over Coronavirus
Paul Blest reports in Vice News:
After he helped organize some of his fellow workers to walk out at an Amazon warehouse on Staten Island over coronavirus-related safety concerns, Chris Smalls was fired from his job. Amazon says he violated a company order to self-quarantine and put his fellow workers at risk of contracting the coronavirus; he says it’s retaliation.
“It’s a shame on them,” Smalls told VICE News. “This is a proven fact of why they don’t care about their employees, to fire someone after five years for sticking up for people and trying to give them a voice.”
Amazon says that they fired Smalls for “violating social distancing guidelines and putting the safety of others at risk.”
“He was found to have had close contact with a diagnosed associate with a confirmed case of COVID-19 and was asked to remain home with pay for 14 days, which is a measure we’re taking at sites around the world,” Amazon said in a statement provided to VICE News. “Despite that instruction to stay home with pay, he came onsite today, March 30, further putting the teams at risk. This is unacceptable and we have terminated his employment as a result of these multiple safety issues.”
Amazon has publicly confirmed that two workers at the JFK8 warehouse have tested positive for coronavirus, though Smalls told VICE News Monday that he believes several more workers have contracted the illness than Amazon is publicly confirming. . .
A Medical Anthropologist Tells Us Why She Was So Wrong About Coronavirus
Matthew Gault writes in Vice’s Motherboard:
In the early days of the coronavirus pandemic, many public health experts were sure that the virus could be beaten before it had a disastrous impact: as long as testing was robust, and the systems in place functioned properly, America would pull through relatively unscathed.
They may have been right, but we’ll never know, because testing has not been robust, and the systems in place have all failed miserably.
One expert I spoke with in late February was Theresa MacPhail, a medical anthropologist, Assistant Professor at Stevens Institute of Technology, and author of the book The Viral Network: A Pathology of the H1N1 Influenza Pandemic. MacPhail worked with the CDC in 2009 as a volunteer intern as part of its Global Disease & Detection unit, taking part in global conference calls on the H1N1 pandemic and seeing how the organization is structured. She was in Hong Kong during its H1N1 outbreak.
In late February, she spoke optimistically with me about America’s ability to handle the coming Covid-19 outbreak. In early March, she got sick with what she believes to be Covid-19. She reached out to me recently, insisting to go on the record again to say that she was wrong, and that she put too much faith in the CDC and America’s ability to manage the crisis.
How are you feeling?
I feel guilty. I feel like I should have known better.What was it about our previous conversation that made you feel guilty?
I made a lot of assumptions and didn’t think twice about having made them. I know I’m not alone, I’m just one of the only people that is saying publicly, “Well, I got this completely wrong.”I think it was overconfidence. I feel like what we’re seeing is a bit of hubris. We’re basically suffering, partially, because there was no plan for when the [Center for Disease Control] fucked up, because they don’t fuck up, or they haven’t in the past. They don’t have a protocol for when they can’t do an assay. And that’s exactly what happened. Their assays didn’t work. And there was no plan for that.
What do you mean by an assay?
I just assumed that the US system would be a little bit better, would be a little bit more robust and do more testing and containment than China was able to do, and I just couldn’t have been more wrong.When we talked, I was still so confident that this response was gonna look like the 2009 [H1N1] pandemic response, which was a good response. Initially, it had some problems… but once they realized what was going on, they kicked into gear and everything went pretty well.
One thing that’s super different is that the CDC in 2009 provided central leadership. They were proactively reaching out to state, regional, and local Health officials saying, ‘Here’s what you need to be doing. Here’s what this should look like.’ And people did it.
I am scared and enraged because there’s no central authority here. I don’t understand what’s going on.The CDC isn’t giving press briefings. They’re just absent. And that could be because the administration is muzzling them. Or it could mean that there’s disarray inside the CDC. And I guess all of that will come out.
But I feel guilty because I knew them. So it’s a bit like not wanting to think your Uncle Bob did something wrong or was capable of doing something wrong. That’s why I feel bad, because I just assumed that this response would look like the old response. And it doesn’t at all, and I just feel so awful.
I wasn’t one of those people sounding the warning alarm. I really felt like we had a shot at containing [it]. But that meant that we had to have tests. I didn’t realize what 10 years of underfunding public health had done.
You got sick after we spoke last, right?
I was never tested, but if I had to lay bets I would say I have it. I’m still sick now. I’m on day 25. I got sick on March 1. It was the classic sore throat, feeling a little bit disgusting, and then at day five or six my fever started to spike. It got as high as 102.5 and never went below 100, despite taking massive amounts of fever reducer.I started having tightness in my chest. I had a dry cough. I went to the ER on March 9. They put me in a separate room. Before all this went down, I had been contacted to go to Washington to the House of Representatives and give a public statement before Congress about what we’ve learned in pandemics past. Of course, that all got shot out of the water.
I asked the ER doctor, “Can you tell me in your professional opinion, are you prepared for this?” He said, “Absolutely not.” He had been doing this for 12 years. He was there for the 2009 pandemic. He said in 2009 they were overprepared. They had extra flu kits, they had extra supplies, they were ready. They had been prepared by the Department of Health. The communication had been clear. He said, “I hate to tell you this but we’re underprepared now. We don’t have extra supplies. We don’t have any tests.” That’s when I started to think, “This is serious.”
The only way we get out of this, the only way we return to a semblance of normal, is massive testing. And I’m starting to get worried because when are we doing that? It’s mind boggling.
You’ve mentioned a few times that past responses were better. What do you mean? . . .
Kushner Firm Built the Coronavirus Website Trump Promised
Self-dealing is the norm with the Trump administration. Robinson Meyer writes in the Atlantic:
On March 13, President Donald Trump promised Americans they would soon be able to access a new website that would ask them about their symptoms and direct them to nearby coronavirus testing sites. He said Google was helping.
That wasn’t true. But in the following days, Oscar Health—a health-insurance company closely connected to Trump’s son-in-law, Jared Kushner—developed a government website with the features the president had described. A team of Oscar engineers, project managers, and executives spent about five days building a stand-alone website at the government’s request, an Oscar spokesperson told The Atlantic. The company even dispatched two employees from New York to meet in person with federal officials in Washington, D.C., the spokesperson said. Then the website was suddenly and mysteriously scrapped.
The site would not have helped many Americans even if it had launched. Today, more than two weeks after the president promised a national network of drive-through test sites, only a handful of such sites have opened, and fewer than 1 million Americans have been tested.
The full extent of Oscar’s work on the project has not been previously reported. The partnership between the administration and the firm suggests that Kushner may have mingled his family’s business interests with his political interests and his role in the administration’s coronavirus response. Kushner’s younger brother Joshua is a co-founder and major investor in Oscar, and Jared Kushner partially owned or controlled Oscar before he joined the White House. The company’s work on the coronavirus website could violate federal ethics laws, several experts said.
For the past several weeks, Kushner has led a “shadow task force” on the coronavirus, separate from Vice President Mike Pence’s official committee, according to The Washington Post. Kushner’s team, composed of federal officials allied with Kushner and outside corporate executives, has met in the headquarters of the Department of Health and Human Services. A senior official at that agency called Oscar to ask for its help on March 13, the day of Trump’s press conference, the Oscar spokesperson said.
Kushner’s group has focused on expanding and publicizing coronavirus testing, especially at drive-through locations. Oscar’s website would have asked users if they were experiencing symptoms of COVID-19, the illness caused by the virus, and surveyed them about other risk factors, including their age and preexisting conditions. It also would have listed a limited number of testing locations nationwide, including some of the drive-through sites that Trump promised. It was designed to look like a government-developed product, provided freely by the Department of Health and Human Services to the American public. Oscar posted the source code for the site to Github, where The Atlantic reviewed it.
Read: How the pandemic will end
The site resembled a version of a tool Oscar had already built for its customers in response to the crisis, but it was “adjusted to meet the specifications and requirements set by the federal government,” Jackie Kahn, the Oscar spokesperson, said in an emailed statement. That Oscar had already been working on a coronavirus-testing website when HHS called to ask for help was a coincidence that had nothing to do with Kushner, Kahn suggested. She declined to say whether Oscar had discussed that site with Joshua Kushner or any board members or investors before Trump’s March 13 press conference.
Oscar donated its work freely and never expected to be paid for the project, Kahn said. The company is “not, nor has ever been,” a contractor or subcontractor for the government, she said, which would make it harder for the government to pay Oscar for its work. The work was “all at the direction of HHS,” she said. “The website never saw the light of day,” she added in an interview today.
That may not matter from an ethics perspective. The ad hoc nature of Kushner’s task force has already collided with federal laws. Oscar’s involvement deepens Kushner’s ethics and conflict-of-interest problems.
“It’s not typical. It’s usually not allowed,” Jessica Tillipman, an assistant dean at the George Washington University School of Law and an expert on anti-corruption law, told me.
Oscar’s relationship with the Trump administration could breach federal law in two ways, Tillipman and other experts told me. First, companies are generally not supposed to work for the federal government for free, though some exceptions can be made in a national emergency. “The concern, when you have some free services, is that it makes the government beholden to the company,” Tillipman said.
More important, she said, any Kushner involvement may have violated the “impartiality rule,” which requires federal employees to refrain from making decisions when they even appear to involve a conflict of interest. The rule also prohibits federal employees from making a decision in which close relatives may have a financial stake. Such a situation would seem to apply to Kushner and Oscar. In 2013, Jared and Joshua were the “ultimate controlling persons in Oscar’s holding company,” according to a New York State report that Mother Jones dug up earlier this month. . .
Experimental AI tool predicts which COVID-19 patients develop respiratory disease
ScienceDaily has an interesting report:
An artificial intelligence tool accurately predicted which patients newly infected with the COVID-19 virus would go on to develop severe respiratory disease, a new study found.
The work was led by NYU Grossman School of Medicine and the Courant Institute of Mathematical Sciences at New York University, in partnership with Wenzhou Central Hospital and Cangnan People’s Hospital, both in Wenzhou, China.
Named “SARS-CoV-2,” the new virus causes the disease called “coronavirus disease 2019” or “COVID-19.” As of March 30, the virus had infected 735,560 patients worldwide. According to the World Health Organization, the illness has caused more than 34,830 deaths to date, more often among older patients with underlying health conditions. The New York State Department of Health has reported more than 33,700 cases to date in New York City.
Published online March 30 in the journal Computers, Materials & Continua, the study also revealed the best indicators of future severity, and found that they were not as expected.
“While work remains to further validate our model, it holds promise as another tool to predict the patients most vulnerable to the virus, but only in support of physicians’ hard-won clinical experience in treating viral infections,” says corresponding study author Megan Coffee, MD, PhD, clinical assistant professor in the Division of Infectious Disease & Immunology within the Department of Medicine at NYU Grossman School of Medicine.
“Our goal was to design and deploy a decision-support tool using AI capabilities — mostly predictive analytics — to flag future clinical coronavirus severity,” says co-author Anasse Bari, PhD, a clinical assistant professor in Computer Science at the Courant institute. “We hope that the tool, when fully developed, will be useful to physicians as they assess which moderately ill patients really need beds, and who can safely go home, with hospital resources stretched thin.”
Surprise Predictors
For the study, demographic, laboratory, and radiological findings were collected from 53 patients as each tested positive in January 2020 for the SARS-CoV2 virus at the two Chinese hospitals. Symptoms were typically mild to begin with, including cough, fever, and stomach upset. In a minority of patients, however, severe symptoms developed with a week, including pneumonia.
The goal of the new study was to determine whether AI techniques could help to accurately predict which patients with the virus would go on to develop Acute Respiratory Distress Syndrome or ARDS, the fluid build-up in the lungs that can be fatal in the elderly.
The Unbelievable Tale of Jesus’s Wife
Ariel Sabar has in the Atlantic a lengthy but fascinating account of his tracking down how that papyrus fragment that referred to the wife of Jesus came about. It reads like a Dan Brown novel (one of which may have sparked the idea), but without the violence. The academic who pushed the papyrus fragment, Karen King, comes out looking not very good. The story begins:
On a humid afternoon this past November, I pulled off Interstate 75 into a stretch of Florida pine forest tangled with runaway vines. My GPS was homing in on the house of a man I thought might hold the master key to one of the strangest scholarly mysteries in recent decades: a 1,300-year-old scrap of papyrus that bore the phrase “Jesus said to them, My wife.” The fragment, written in the ancient language of Coptic, had set off shock waves when an eminent Harvard historian of early Christianity, Karen L. King, presented it in September 2012 at a conference in Rome.
Never before had an ancient manuscript alluded to Jesus’s being married. The papyrus’s lines were incomplete, but they seemed to describe a dialogue between Jesus and the apostles over whether his “wife”—possibly Mary Magdalene—was “worthy” of discipleship. Its main point, King argued, was that “women who are wives and mothers can be Jesus’s disciples.” She thought the passage likely figured into ancient debates over whether “marriage or celibacy [was] the ideal mode of Christian life” and, ultimately, whether a person could be both sexual and holy.
King called the business-card-size papyrus “The Gospel of Jesus’s Wife.” But even without that provocative title, it would have shaken the world of biblical scholarship. Centuries of Christian tradition are bound up in whether the scrap is authentic or, as a growing group of scholars contends, an outrageous modern fake: Jesus’s bachelorhood helps form the basis for priestly celibacy, and his all-male cast of apostles has long been cited to justify limits on women’s religious leadership. In the Roman Catholic Church in particular, the New Testament is seen as divine revelation handed down through a long line of men—Jesus, the 12 apostles, the Church fathers, the popes, and finally the priests who bring God’s word to the parish pews today.
King showed the papyrus to a small group of media outlets in the weeks before her announcement—The Boston Globe, The New York Times, and both Smithsonian magazine and the Smithsonian Channel—on the condition that no stories run before her presentation in Rome. Smithsonian assigned me a long feature, sending me to see King at Harvard and then to follow her to Rome. I was the only reporter in the room when she revealed her find to colleagues, who reacted with equal parts fascination and disbelief.
“The Gospel of Jesus’s Wife” papyrus (Karen L. King / Harvard / AP)
Within days, doubts mounted. The Vatican newspaper labeled the papyrus “an inept forgery.” Scholars took to their blogs to point out apparent errors in Coptic grammar as well as phrases that seemed to have been lifted from the Gospel of Thomas. Others deemed the text suspiciously in step with the zeitgeist of growing religious egalitarianism and of intrigue around the idea, popularized by The Da Vinci Code, of a married Jesus. The controversy made news around the world, including an article in these pages.
A year and a half later, however, Harvard announced the results of carbon-dating tests, multispectral imaging, and other lab analyses: The papyrus appeared to be of ancient origin, and the ink had no obviously modern ingredients. This didn’t rule out fraud. A determined forger could obtain a blank scrap of centuries-old papyrus (perhaps even on eBay, where old papyri are routinely auctioned), mix ink from ancient recipes, and fashion passable Coptic script, particularly if he or she had some scholarly training. But the scientific findings complicated the case for forgery. The Gospel of Jesus’s Wife had undergone—and passed—more state-of-the-art lab tests, inch for inch, than almost any other papyrus in history. . .
Continue reading. This is just the beginning…
A great shave and a fine-bristled brush
I noticed (perhaps again) how very fine are the bristles of this Yaqi brush. The synthetic knot is in a “Target Shot” pattern, modeled (I’m told) on the quadrant aiming pattern used by submarines in WWII. I shook out all excess water and got an excellent lather from Phoenix Artisan’s Avo Nice Shave shaving soap.
The Yaqi DOC razor, in a cammo pattern to match the brush handle, is an very good razor and I easily achieved a BBS result in three smooth and trouble-free passes. A splash of Avo Nice Shave aftershave, and I’m back to unpacking and organizing.
Later On 